1. Field of Invention
This invention relates to a device for fixation of a fractured jaw, and more specifically to a fixation device for locking the teeth of the upper and/or lower jaw for therapeutic purposes.
2. Description of the Related Art
Medical treatises advise that mandibular simple and compound fractures can be treated by closed reduction and indirect skeletal fixation of the lower or upper jaw. Prior devices have been utilized for locking the teeth of the lower jaw (the mandible) together, for locking the teeth of the upper jaw (the maxilla) together, and for locking the upper and lower jaws together to allow a broken maxilla or mandible to heal after a fracture. The prior devices utilized a multitude of wires, plates, connectors, arch bars, and screws that are cumbersome and time consuming to install in the moist and limited space of a patient's mouth. One of the multitude of pieces utilized to fixate the jaws and teeth could easily be left unattached in the patient's mouth and potentially swallowed by the patient. In addition, the prior devices typically required an extensive time for installation within the patient's mouth, requiring general anesthesia for the patient during installation.
Typical of the prior art are those jaw fixation devices disclosed in the following U.S. Patents. In U.S. Pat. No. 5,842,856, to Casey, a release system for treatment of a broken jaw is disclosed that includes an upper and lower arch bar that is attachable on the outer sides of the teeth. A release bar is insertable through a plurality of loops extending downward from the upper arch bar, with a similar release bar extending upwards from the lower arch bar, allowing wires to be threaded between loops of the upper release bar and loops of the lower release bar to secure the outer sides of teeth of the upper jaw to the outer sides of teeth of the lower jaw. The plurality of loops of each release bar are attached to hangers that must be secured to the exterior sides of the teeth by wrapping ligature wire around the teeth at the gum level and threading the wire through the hangers. The use of ligature wire presents the opportunity of breakage of wires, the risk of puncture of tissue within the mouth, and the need for re-wrapping of each release bar and associated hangers with ligature wire during replacement of broken wires of either upper or lower arch bars. The release bars and hangers are not used on the interior of teeth.
In U.S. Pat. No. 4,872,449, to Beeuwkes, a quick-release device for maxillomandibular stabilization is disclosed that includes a plurality of splints or units of interfitting connector plates. The plates are interconnected with archwire passing through interfitting slots in each connector plate. Each connector plate is connected to the outside exterior of adjacent teeth by U-shaped anchor members such as wires that encircle the teeth and have threaded extremities that pass through holes in the connector plates. Retainer elements such as screws or retainer nuts are screwed onto the threaded extremities for holding the connector plates tightly against the outside exterior of adjacent teeth. The interfitting connector plates form a set including one plate for one or two lower teeth and a separate plate for one or two upper teeth, are interconnected with the archwire, which serves as an exterior or buccal retainer bar. The retainer elements are screwed onto the exterior or buccal side of the teeth. Each unit of connector plates that locks an upper and lower tooth together can include approximately eight pieces that must be removed before a segment of upper and lower teeth are freed from containment, thereby requiring use of, and removal of, a plurality of small items from the mouth of the patient before the patient's jaw is movable. The plurality of small items are cumbersome to install in the moist confines of a patient's mouth and requires scrutiny to minimize loss of connector plates, retainer elements, and/or anchor members within the patient's mouth.
In U.S. Pat. No. 4,813,869, to Gatewood, a jaw fixation assembly is disclosed that includes anchor members that encircle each tooth. Each anchor member includes bendable wires that form around the lingual surfaces of each tooth, with the ends of the wires extending on the buccal side of each tooth, and each wire end secured by retainer members that are screwed onto the wire ends projecting between the teeth. A metal band can be attached between the buccal ends of the wires projecting between the teeth, with the retainer members screwed onto the wire ends extending on the exterior side of each tooth. A plurality of ligature wires can be attached between the retainer members located on the exterior or buccal sides of the maxillary teeth, to the retainer members located on the exterior or buccal sides of the mandibular teeth. The jaw fixation assembly requires at least four parts for fixation of each tooth, with no common arch bar established around the exterior, or within the interior side of the teeth. A plurality of ligature wires is required to secure the maxillary teeth to the mandibular teeth. A special elongated tool is required for tightening each anchor member on the ends of each bendable wire encircling the teeth.
In U.S. Pat. No. 4,230,104, to Richter, an orthodontic appliance is disclosed that comprises a malleable upper and lower arch bar having exterior ligature wire that are adaptable around the individual teeth to hold the teeth, with a prong and tab projecting from the exterior surface of the arch bars. The prong and tab structure provides attachment points for ligature wires that can be wrapped between the upper and lower arch bars. The appliance only provides an arch bar on the exterior of the teeth, and is not easily removable due to the multiple prongs, tabs, and ligature wires that must be loosened and removed from the upper and lower arch bars to separate the patient's jaws.
U.S. Pat. No. 2,481,177, to Tofflemire, discloses an appliance for holding undamaged teeth together while a fractured jawbone heals, the appliance comprises individual abutments or fixation blocks that are secured to anchor teeth, with wire staples passing around the anchor teeth and through bores in the abutments to secure the anchor teeth to the abutments. Wire interconnections between upper and lower abutments and alignment bars are installed and removed with special cutting, pulling, and crimping tools.
Therefore, it is an object of the present invention to provide an apparatus for fixation of some or all of the teeth of the upper jaw together.
It is another object of the present invention to provide an apparatus for fixation of the some or all of the teeth of the lower jaw together.
It is another object of the present invention to provide an apparatus for fixation of teeth of the upper jaw and the teeth of the lower jaw, along with fixation of the upper and lower jaws together.
It is another object of the present invention to provide an apparatus for expedited installation under local anesthesia of maxillomandibular fixation arch bars to lock teeth to be fixated of the upper and lower jaws together.